Study to Identify the Risk Factors and their Relationship with Mucormycosis Severity in COVID Pneumonia

Background: Mucormycosis is an infection caused by a fungus that is present naturally in the environment. There has been an increased number of mucormycosis infections reported during COVID-19 and post COVID period. Dysregulated immune system due to COVID-19 and steroid use in the treatment which suppresses the immune system predisposes to this fungal infection. Patients with Diabetes Mellitus & those who receive humidified oxygen during COVID-19 are found to be at higher risk of developing mucormycosis. Methodology: 60 patients with mucormycosis admitted in the mucormycosis ward of SVRRGGH, Tirupathi, Andhra Pradesh, India in June 2021 are enrolled and retrospectively studied. Data were collected according to prestructured proforma about risk factors which include the previous history of Diabetes, CT severity score during COVID-19, and use of steroids and oxygen during the period of COVID-19. Results:  A total of 60 patients with mucormycosis were included in the study with a mean age of 49.25+/-10.29. 80% of the patients were males & 20% were females. 38.33% had mild COVID-19 (CTSS 0-7), 45% had moderate disease (CTSS 8-17) and 16.66% had severe disease (CTSS 18-25). 70% had stage 2, 18.33% had stage 3 and 10% had stage 4 mucormycosis. Out of total patients, 78.33% were found to have a previous history of diabetes or newly detected diabetes. 60% of the patients had a history of humidified oxygen inhalation & 58.33% of the patients had received steroids during COVID-19. Conclusion: Male preponderance was observed in the study. Diabetes Mellitus, steroid use, humidified oxygen usage are the identifiable risk factors in mucormycosis associated with COVID-19. CT severity score is directly proportional to mucormycosis severity in the present study.